Purpose: Aim of our study was to evaluate the clinical utility of Dobutamine CMRI stress in patients with atypical chest pain or in equivocal ECG stress test not suitable for stress echocardiography Methods and Materials: 33 patients (22M, 11F, mean age 62,4) underwent MRI (1,5 T, GE HD). We used a 8 channel phased array dedicated coil. One was excluded for systemic hypertension. Cine steady state MRI sequences with parallel imaging in 4-chambers view and six adjacent short axis planes were obtained at rest. After baseline acquisition dobutamine was administered from a dose of 5 µg/kg/min to a dose of 40 µg/kg/min (quantity varied every 3 minutes) using an amagnetic injector . After dobutamine injection six adjacent short axis planes were scanned. MR images were analyzed both at rest and during incremental dosage of dobutamine to assess regional wall motion by Segment® software analysis. Patients were considered positive for coronary artery disease (CAD) if any new or worsening wall motion abnormality developed. 22 patients underwent coronary arteriography. The remaining ten patients were monitorized for a period of time of at least nine moth; in this time none of them presented new coronary event and they were considered free of coronary disease Results: During dobutamine peak stress wall motion asynergy developed or worsened in 7 patients, yielding an overall sensitivity in CAD detection of 85% and a specificity of 100% Conclusion: Dobutamine MRI using six slices analysis is an accurate method for the assessment of myocardial ischemia in patients with CAD
Dobutamine stress magnetic resonance imaging in patients with atypical chest pain or equivocal ECG not suitable for stress echocardiography: Six slices evaluation
DI CESARE, Ernesto;MASCIOCCHI, CARLO
2010-01-01
Abstract
Purpose: Aim of our study was to evaluate the clinical utility of Dobutamine CMRI stress in patients with atypical chest pain or in equivocal ECG stress test not suitable for stress echocardiography Methods and Materials: 33 patients (22M, 11F, mean age 62,4) underwent MRI (1,5 T, GE HD). We used a 8 channel phased array dedicated coil. One was excluded for systemic hypertension. Cine steady state MRI sequences with parallel imaging in 4-chambers view and six adjacent short axis planes were obtained at rest. After baseline acquisition dobutamine was administered from a dose of 5 µg/kg/min to a dose of 40 µg/kg/min (quantity varied every 3 minutes) using an amagnetic injector . After dobutamine injection six adjacent short axis planes were scanned. MR images were analyzed both at rest and during incremental dosage of dobutamine to assess regional wall motion by Segment® software analysis. Patients were considered positive for coronary artery disease (CAD) if any new or worsening wall motion abnormality developed. 22 patients underwent coronary arteriography. The remaining ten patients were monitorized for a period of time of at least nine moth; in this time none of them presented new coronary event and they were considered free of coronary disease Results: During dobutamine peak stress wall motion asynergy developed or worsened in 7 patients, yielding an overall sensitivity in CAD detection of 85% and a specificity of 100% Conclusion: Dobutamine MRI using six slices analysis is an accurate method for the assessment of myocardial ischemia in patients with CADPubblicazioni consigliate
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